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Objective Criteria for Crohn-like Lymphoid Reaction in Colorectal Cancer

2013; Oxford University Press; Volume: 139; Issue: 4 Linguagem: Inglês

10.1309/ajcpwhueftgbwke4

1943-7722

Hideki Ueno, Yojiro Hashiguchi, Hideyuki Shimazaki, Eiji Shinto, Yoshiki Kajiwara, Kuniaki Nakanishi, Kei Kato, Kazuya Maekawa, Kosuke Miyai, Takahiro Nakamura, Junji Yamamoto, Kazuo Hase,

Colorectal Cancer Screening and Detection

We aimed to determine semiquantitative evaluation criteria for Crohn-like lymphoid reaction (CLR). We reviewed 1,032 patients with colorectal cancer and evaluated CLR by counting all peritumoral lymphoid aggregates (LAs) and by measuring the maximum diameter of the largest LA. The maximum diameter of the largest LA, rather than the number, had a significant impact on survival. Active CLR determined by the 1-mm rule was significantly associated with MLH1/MSH2 immunohistochemical staining deficiency. The group with LAs 1 mm or larger had lower recurrence (P = .0008) and a higher survival rate (P < .0001) than that without LAs 1 mm or larger. These results were similarly observed in another cohort of 500 patients with colorectal cancer. The k values for CLR evaluation among 8 observers were 0.67 for the 1-mm rule and 0.50 for Graham's criteria. The size of the largest LA best reflects the specific characteristics of CLR, and the 1-mm rule is expected to improve assessment reproducibility.